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Everything you need to know about Laser Tattoo Removal

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As more and more people are getting tattoos, there is an increasing demand to get them removed. Whether the tattoo was a mistake from the get go, it didn’t turn out as you expected, or a relationship has changed and you want to remove your “ex” from your skin, the most common way to remove tattoos is with a laser. The only other option is to surgically excise the tattoo which can realistically be done only for smaller tattoos and it always leaves a scar.

A Q-switched laser is needed to removed tattoos. What’s unique about this type of laser is that its pulse duration (how long the time is which it fires it energy) is in the nanosecond range. By making the pulse this short, it makes the energy level of the pulse in the billions of watts. That huge energy hit to the tattoo causes a shock wave in the tattoo pigment which leads to the pigment breaking up into smaller pieces. Once the particles of the tattoo pigment get pulverized to a certain size, they are small enough for the body to “chew them up” and remove them from the body. Using traditional laser tattoo removal techniques, it takes multiple treatments, 10-15, to get complete tattoo removal. Often the waiting between treatments is up to 2 months, so it can take a year to 2 to removal a tattoo.

There is a newer technique called the R0 protocol for tattoo removal which will remove tattoos much faster than traditional techniques. The R0 protocol entails treating the tattoo 4 times in the same day. There is a liquid placed on the tattoo which removes the frosting which occurs (from heating nitrogen in the skin) so you can immediately proceed to another pass. Studies show much faster eradication, 1-4 sessions, with no more risks or side effects.

What type of Q-switched laser is the best? The safest wavelength for treating skin of all colors is the 1064 nm Nd:YAG laser. There is less pigmentation side effects and less textural changes with the 1064 Q switched laser than with the Alexandrite and Ruby laser. Sometimes, after treating with this wavelength, residual pigment remains, and that’s when other wavelengths are needed. You also want to look for a laser that has a “tophat” distribution of its pulse energy. What this means is that the energy is evenly distributed across the entire spot size to give a uniform treatment. If this is not the case, the tattoo can be under or over treated in some areas. The shorter duration of the pulse, the better safety profile, and the better results. The short pulse allows for less diffusion of the energy to nearby skin so as to leave this skin unaffected. It also allows for greater energy levels on the treated area.

Top Hat energy distribution of the Spectra laser. Left=others, Right=Spectra

Side effects from Laser Tattoo Removal are: scarring, hypopigmentation, hyperpigmentation, incomplete tattoo removal, and rare allergic reaction to the dyes of the tattoo. Darker skin individuals are at higher risks of complications than lighter skin individuals.

The Lutronic Spectra Q-Switched Laser seems to be an ideal laser for tattoo removal.

An extremely short pulse duration which leads to high peak energies
Based on 1064nm Nd:YAG platform
Has multiple other wavelengths for difficult pigment (4)
“Tophat” energy pulse profile
Dual energy generators to prevent loss of energy during prolonged laser firing

Energy output showing the high peak energy of the Spectra laser

Using the Kirby-Desai Scale, you can determine how many treatments it should take to improve the tattoo (within 80% accuracy) http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2923953/

For further information about Lutronic Spectra Q-Switched laser tattoo removal, please call our office at 850.622.1214.

Dr. Steven Weiner is a Board Certified Facial Plastic Surgeon practicing in Santa Rosa Beach, Florida, between Destin and Panama City Beach, Florida. After laying down his scalpel in 2005 he has devoted his practice to Lasers and Injectables.

Blog: http://stevenfweinermd.wordpress.com/

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Website: http://www.theclinique.net

The various treatments for Acne Scars (scarring) at The Aesthetic Clinique

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Dr. Weiner answers questions about acne scars

Acne scarring is a very prevalent problem in our society. It also a very common concern for clients in our office because it most often affects the face and becomes a cosmetic concern. Treatment options are based of the severity of the disease and the intensity/aggressiveness the client desires. One must accept the fact that scarred skin will never improve 100%. However, once a scar in improved, it should persist indefinitely, unless further acne causes more scarring.

UPDATE: We now offer Infini, a radiofrequency microneedling device. This appears to be a great alternative to laser for acne scars. Please read the link.

Topical treatments are needed for all cases acne scarring. The regime should include: Retin A or Retinoid, serum with growth factors (TNS Essential Serum or Lifeline), and sunscreen.

Early scarring, which is the result of recent acne can be treated best with the VBeam. The VBeam will help with the redness and hopefully slow or prevent the progression of the scar turning into a mature and firm scar. The VBeam also helps with future acne breakouts.

Ice pick scarring can be treated with punch excision which involves removing the scar in a sleeve like fashion and closing the skin with a stitch. The more preferred way at our office is to use high concentration TCA and to chemically burn each individual scar in a series of 4 or 5 treatments. This method is called TCA Cross technique.

For more severe global acne scarring, the Fraxel Dual 1550 nonablative laser is probably the gold standard. This laser has more studies and experience treating acne scarring than any other laser. There is some mild swelling for a few days but no open wounds to dress. Peeling occurs for a few days a well. The number of treatments varies according to severity of disease and desired effect, but could be up to 10 treatments. It is safe for all skin types. Ablative erbium or CO2 lasers are used for acne scarring as well but we don’t have these lasers in our office. It’s been our experience that patient’s prefer the less invasive lasers with less wound care. less risk, and downtime.

For minimally depressed scars, using dermal fillers like Restylane can be a quick and easy medium term (9-12 months) improvement. Artefill has just published a study and will probably get FDA approval for acne scars in the near future.

There is research being done for using Ulthera, LaViv, and stem cells for acne scars as this blog is being written.

In general, there are several different choices to treat acne scars. Lasers are required for the most severe cases. Treating acne aggressively to prevent scarring is obviously highly recommended because treating the scarring is much more difficult.

What are realistic expectations for noninvasive cosmetic procedures?

As the number of physicians providing noninvasive cosmetic services increases, there is a tendency for many to make unsubstantiated claims as to what outcomes can be expected. This ultimately can lead to unhappy patients and certain procedures can be tarnished in reviews or in the press for not living up to what was promised. Patients need to be careful if something sounds too good to be true. In addition, patient’s sometimes expect way too much from a procedure, often well beyond what the procedure is capable of, and need to discuss what they want, in detail, with the physician before agreeing to it.

Some of the most common misconceptions are:

Most people need several different procedures, not just one to become more youthful. Don’t expect one treatment (or series) with a laser or skin tightener to be all that is needed. The Fraxel (Dual, re:pair) will make your skin less wrinkled, tighter, and more clear. Will it make you look “10 years younger” as some physicians claim. Probably not. The majority will look better but not by 10 years and will need other modalities such as filler and Botox to complete the youthful correction.
Don’t expect to have significant results from any cellulite treatment except for Cellulaze. All other treatments (Velasmooth, Velashape, Endermologie) are very temporary and end up being costly and time consuming. From the presentations I’ve seen with Cellulaze, there are significant long term results which are impressive.
Laser hair removal will not allow you to “throw away your razor”. Complete hair removal is not possible with any of the lasers which remove hair. You can expect up to 75-80 improvement with a series of about 6 treatments in the bikini and underarm area in most cases. Back, chest, and legs require more treatments, maybe up to 10. Darker skin individuals can require more treatments too because the laser needs to be turned down on these patients. Extremely fine hair on the face probably shouldn’t be treated at all because of the risk of making the problem worse. For all areas, touch ups every 6-12 months are required.
Some physicians were claiming Zerona was a weight loss (“fat zapping laser”) and slimming technology. This claim was completely unsubstantiated. There were no studies which showed long-term improvements with the technology and none which showed weight loss. The company is now bankrupt. Enough said.
A syringe of Restylane or Juvederm can’t usually make a significant improvement in volume in the face. Keep in mind that a syringe of these fillers is 1cc. There are 5cc in a teaspoon. So a syringe of the filler is a fifth of a teaspoon. In severely volume depleted patients, it’s not uncommon to use 4-8 syringes in one sitting. Some dissatisfaction commonly expressed on RealSelf.com are from patient’s which feel that there was no result with a filler procedure or that the filler was metabolized in a week or two. In actuality, they were expecting way too much from that fifth of a teaspoon. (In the lips, one syringe can make a noticeable improvement. This discussion is directed towards the patient needing volumization of face.)
Botox or Dysport is great for improving wrinkles which appear with expression but the wrinkles which are there at rest are helped to a much lesser degree. If you spread out your frown line and there is still a groove, this will not improve with Botox at one session and either requires multiple treatments to improve or the use of dermal fillers. Also remember, everything returns back to baseline unless injections are repeated every 3-4 months.
For an extremely strong frown line, complete “freezing” of the muscles is not possible. Studies show Botox can improve the frown line 1 or 2 grades (there are 4 grades/degrees of strength). You can’t go from a 4 to a 1 in one session.
Ulthera won’t give you a result that is comparable to a facelift. It will however give noticeable improvements for a procedure which takes about an hour with no long-term risks or downtime. Repeated treatments will give even further improvements. We send patients to be evaluated for surgery if they want tightening beyond what we can deliver with the Ulthera. Most still come back and request treatment from us.
Acne scars cannot be eradicated with any laser. You can expect up to about 50-60% improvement with the Fraxel Dual. This can take up to 10 treatments for the severely scarred patient.
Results for treating a smoker’s face will be diminished when compared to a nonsmoker. Smoking decreases the circulation to the facial skin by up to 60%. With this decreased “nourishment” to the skin, healing, collagen stimulation, tightening are all going to be significantly less. Smoking accelerates the aging of the face.
If you are 60-65 and are considering cosmetic procedures for the very first time, it’s been my experience that expectations from noninvasive procedures are unrealistic. Multiple procedures are required including: dermal fillers, Ulthera, skin care, peels, and possibly laser to turn back the clock. Thinking that a Botox treatment or a syringe or 2 of filler will do the trick is very unrealistic. I suggest that these patients consider surgical intervention, but if that’s not what they desire, we can definitely make noticeable improvements, but it takes time and multiple procedures.

In conclusion, this is an era of the minimal invasive cosmetic procedures. The future looks even more promising as to new procedures with even greater results and with more indications. Just make sure that you go to a trusted physician that can give you realistic expectations.

Do Dermal Fillers (Restylane, Juvederm, Belotero) fight cancer?

I stumbled across a very interesting article last night. It discussed how the naked mole rat had some very unique qualities. I has a very long life span for a rodent, up to 30 years vs. 3-4 years for most species, and it doesn’t get cancer!

After studying tissue cultures from the rat, they found that it had an unusually high level of Hyaluronic Acid (HA or HMW-HA) per Dr. Gorbunova and Dr. Seluanov, professors at the University of Rochester in New York. Apparently this is needed for the rat to burrow because the rat has no hair and it acts as a sort of “tissue lubricant”. To determine if this was the substance leading to the longevity and anti-cancer protection, they were able to genetically modify the rat so it didn’t produce high levels of HA. Sure enough, the rats started to be susceptible to cancerous tumors!

Is it possible that the Hyaluronic Acid fillers we are using to improve wrinkles and volumize the face (Restylane, Juvederm, Belotero) are having more benefit than making us look good? It is very possible. Human studies will be conducted soon. Get ahead of the curve and get some possible cancer prevention and look younger at the same time by visiting Dr. Weiner at the Aesthetic Clinique in Santa Rosa Beach, Florida for your dermal fillers.

http://www.medicaldaily.com/articles/16694/20130619/cancer-cure-naked-mole-rats-hyaluronan.htm

The best way to get your lips augmented…Hyaluronic Acid Fillers using Blunt Cannulas

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Lip augmentation has received a lot of press over the past couple years and its been mostly bad. That’s because most physicians either overfill the lips or don’t understand what makes lips attractive and natural appearing. In addition, most patients equate lip augmentation to severe pain and several days of downtime with bruising and swelling. I would like to try to convince the public that you don’t have to fear the process of plumping up your lips and don’t have to have days of downtime where you either are hiding in you house or explaining to people that your significant other didn’t beat you.

Blunt cannulas have changed the game for lip augmentation. Through one entry port (which requires a small needle poke) on each side, you can have both upper and lower lips filled with little or no bruising. After applying topical numbing creams to the lips for about 10 minutes, the procedure is very well tolerated. The other advantage is that the swelling is minimized because the lips are minimally traumatized. Many patients go straight out to lunch or drinks or back to work without being self-conscious of people looking at them. On the contrary, traditional lip augmentation using needles requires 4-5 penetrations (each time causing discomfort and risking bruising) per quadrant (so you have to multiply by 4). The blunt cannulas push vessels out of the way with their rounded tips so bruising is minimized. Also, most of the pain is in the surface penetration and once under the surface, the blunt cannulas give less discomfort.

Dental blocks are performed by many of my colleagues. I’m critical of this technique because:

Dental blocks are not comfortable
Often times the block is incomplete so there is still discomfort during the lip injection.
You often stay numb of a prolonged period of time with the associated drooling, etc.
The lip anatomy can be distorted with the block making precise lip enhancement difficult.

Some doctors are critical of using cannulas for the lips because they say the control of placement of the filler is less than when using the needle. Admittedly, there is less precision for the novice, but over time, I’ve become very efficient at using cannulas and there is little difference as far as results. Sometimes, after filling the lips with the cannulas, I will go back into the already numb lip and place minute amounts of filler along the vermilion border or in the tubercles with the needle technique. This usually does not cause significant bruising or swelling.

A natural set of lips is about 33-40% upper lip and 60-66% lower lip. Often doctors will make the lips the same size or the upper lip bigger and this looks very abnormal. Sometimes when the doctor is trying to improve the upper lip lines, this problem occurs by accident. The best way to correct the upper lips lines is to place filler in the area between the lips and nasal area with the cannulas in a horizontal fashion. This usually doesn’t affect the ratio described above. There is loss of bone in the upper jaw as well as loss of fat, and this injection technique replaces those tissue losses and improves the lines. (For more the most severe lines, I will use Belotero into these lines but this is with a needle and does lead to bruising in most cases.) Also, the lip is not supposed to go all the way to the corners. It should gradually taper off on the sides. Those people who get there lips injected evenly all the way across end up with “sausage lips”. Another error is placing too much filler in someones lips. Small lips can only be enhanced to a certain degree before they appear awkward and you look like a “trout mouth”. People with extraordinarily small lips are gradually made larger in my office. Over successive fills, they are slightly larger than their previous treatment. That way you avoid the lips which get through the doorway before the body.

Procedures which should be avoided at all costs, in my opinion are: permanent filler/ implants in the lips or the Valentine lip lift. These lead to abnormal lip appearance, unnatural mobility/movement, long-term complications (firmness, bumps) and unhappy patients. Some patients are trying to avoid repeated injections due to discomfort and resort to these solutions. Don’t do it!! Cannulas offer a more comfortable injection, and overtime, there is collagen stimulation which lengthens the times between treatments. My long-term lip augmentation patients get filled every 9-12 months.

In summary, lip augmentation doesn’t have to prolonged downtime, be considered intensely painful, and look unnatural. Blunt cannulas in the right hands can make for a much more pleasant experience. It’s important to seek out a physician who knows the anatomy of aesthetically pleasing lips and what is needed to achieve those results. Although bruising can occur with cannulas, it usually is minimal or nonexistent, and you can continue your active social schedule after the procedure.

Blog: http://stevenfweinermd.wordpress.com/

YouTube: http://www.youtube.com/user/StevenFWeinerFacial

Website: http://www.theclinique.net

Oral Supplements for Skin Health, Beauty, and Longevity – Heliocare, GliSODin Skin Nutrients, TA65 and Megaresveratrol

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The focus of the Aesthetic Clinique is restoring and optimizing one’s appearance. Skin treatments such as lasers, injectables, and topical creams cannot entirely achieve these results. Hence, oral supplements are needed to help us improve our beauty at the cellular level. The Aesthetic Clinique has been recommending GliSODin Skin Nutrients and Heliocare for over 5 years and we have recently added TA65 to our repertoire.

Heliocare

The first product that we selected almost 7 years ago was Heliocare. Heliocare is an oral supplement used to protect the skin from the sun. UV rays from the sun can increase free radicals on the skin’s surface, which leads to cell damage and premature aging. Antioxidants help to stabilize free radicals within the body. Heliocare uses the natural antioxidants in Polypodium leucotomos extract- derived from a tropical fern plant- to help maintain the skin’s ability to protect against sun related aging. This product has been researched at Harvard Medical School. It is a product of Spain and has been used in Europe for over 30 years, there are no known side effects. Heliocare starts working with the first dose, thirty minutes after taking it. Sunscreen is meant to be used in conjunction with this product. Suggested use is 30 minutes prior to sun exposure and if a full day in the sun is planned a second dose should be taken midday. For clients with melasma recent research has shown this condition to worsen even with visible light. Sunscreens do not provide protection for these wavelengths but Heliocare does, so daily use is highly recommended by Dr. Weiner for melasma suffers.

GliSODin Skin Nutrients

GliSODin Skin Nutrients are a nutritional beauty product line that is taken orally to give you healthy, radiant skin. Formulated by dermatologists and nutritionists the product contains 100% natural ingredients that are easily absorbed into your system. GliSODin is the key ingredient in every GSN product. It is extracted from a non genetically modified melon that contain high levels of SOD (Superoxide Dismutase), also known as “the enzyme of life”. SOD acts as the first line of defense against toxins and cellular breakdown caused by free radicals. GliSODin has a patented protective coating that enables the body to safely absorb the powerful enzyme. Primary antioxidants like SOD have a huge benefit. One SOD molecule can attack a free radical and go on to the next, targeting up to one million free radicals. Secondary antioxidants like Vit C, cocoa and super fruits can only neutralize one free radical at a time. SOD targets free radicals allowing secondary antioxidants to focus on their essential cellular tasks. Aesthetic Clinique has researched this product line, traveling to their headquarters in Toronto to meet with their executive director and endorses it. The GliSODin Skin Nutrients consist of formulas to promote beautiful healthy skin and compliment medical aesthetic procedures. It is recommended to start with the Advanced Detoxification Formula first to help flush out unnecessary and harmful toxins from your system, while promoting total body wellness and increasing energy levels. The Detox not only cleanses your system, it rejuvenates your skin, leaving you with a clearer smoother complexion. Our staff can help you determine which of the formulas to use to address your specific goals and needs. The formulas the Aesthetic Clinique provides include: Advanced Anti-aging Formula to hydrate and nourish your skin, reducing the appearance of fine lines and wrinkles. It provides your skin with nutrients and minimizes the effects of aging by boosting your body’s natural antioxidant system and reducing inflammation, resulting in younger looking skin. Advanced Brightening Formula promotes a bright, smooth and even complexion by helping to repair skin damage caused by exposure to the sun. Used along with a topical SPF, this formula provides you with an extra layer of protection against UV rays, and supports a healthy, even skin especially after aesthetic treatments. It is a great compliment to laser treatments, peels and topical skin brighteners and topical antioxidants. Advanced Slimming Formula is a safe and effective product that promotes healthy weight loss and management by supporting the body for proper metabolism and use of nutrients. By promoting lean muscle mass, balancing sugar levels, controlling appetite and increasing fat metabolism, the Slimming Formula is a safe and effective way to achieve and maintain your weight.

TA 65

TA 65 is a supplement that can help restore telomere length. Telomeres are repetitive DNA sequences located at the ends of chromosomes. Telomeres are responsible for maintaining the integrity of our DNA and play a role in cell aging. Every time a cell divides the telomeres get shorter and when they become critically short, the cell no longer functions properly and dies. A Nobel Prize was awarded for the discovery of the role of telomeres in aging and cell death. Telomerase is the enzyme that maintains telomere length in order to prevent cell death. TA65 is the only proven telomerase activator on the market. It is a single small molecule obtained by ultra purifying and concentrating one of the many bioactive compounds found in the astragalus root. When the telomerase gene is activated it adds new DNA onto the ends of telomeres thus lengthening the shortened telomeres. TA65 is a telomerase activator, which has the ability to activate the telomerase gene to create telomerase. This causes the telomeres to grow longer which allows cells to continue to divide and proliferate. TA 65 was launched in 2007 as a dietary supplement to maintain and improve telomere length and inhibit accelerated aging. Research has shown a wide range of health benefits including improvements in skin elasticity, bone health and insulin balance. It is one of the only supplements that not just stops the clock, but reverses it! There is actually a blood test which can be run to check your telomere length so you can see where you stand before and throughout treatment.

UPDATE: We have added Megaresveratrol, please see the link for more information.

The Combination of Sculptra and Ulthera is better than a Facelift and here’s why!

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Dr. Weiner answers questions about Ulthera

Dr. Weiner answers questions about Sculptra

Let me first explain that I’m a Facial Plastic Surgeon, trained at The Johns Hopkins Hospital. I “laid down my scalpel” in 2005 and since then, have devoted my practice solely to noninvasive and minimally invasive cosmetic procedures. The public has demanded cosmetic enhancement to have little to no downtime, appear natural, and be affordable. Surgical procedures such as facelifts, brow and forehead lifts, blepharoplasty have all had declines in their numbers while injectables, laser resurfacing, and noninvasive skin tightening are continuing to grow at a rapid pace.

Remarkably, it has been only over the last 10 years or so that the aging of the face has been recognized as primarily due to loss of volume. After landmark cadaver dissections, it was shown that there are several different fat pads in the face which all seem to atrophy over time. These are located in the temples, cheeks, under eyes, chin, preauricular (in front of ear) and above the lip. Using CT scan analysis, the boney structure of the face has been shown to change as well. The orbit (eye socket) enlarges leading to hallowing of the eye. The upper and lower jaw retract, and there is bone loss at the angle of the jaw. By losing fat and bone (as well as some muscle), the skin of the face loses support and droops. The strategy in the past by Plastic Surgeons was to cut the excess skin away. This lead to a face with tight skin and less wrinkles, but you looked like a skeleton. These days, it is all about filling the face to replace the lost volume from fat and bone loss.

After the science background above, we can now address why facelifts are a dying procedure. Facelifts have the following undesirable attributes:

Requires a surgical procedure which inevitably leaves some type of incisional scar. Sometimes this is fairly noticeable and requires further procedures (more surgery, laser) or topicals to correct.
There is the risk of anesthesia (cardiac, stroke, pulmonary) and the side effects of anesthesia (nausea, vomiting, etc.).
There is pain requiring pain medication
Recovery time can be lengthy, usually at least a couple weeks, sometimes up to a month for swelling and bruising to subside.
The cost is significant. Frequently a facelift is bundled with neck lift, and blepharoplasty. Adding in the cost of anesthesia and the cost of lost wages for 2-4 weeks, you could easily be looking at $15-20,000.
A facelift does not address volume loss, which would require fat grafting. Fat grafting adds in another cost, another procedure (liposuction), and additional anesthesia time. Fat grafting doesn’t always take, so further procedures are usually needed to get to full volume correction.
Often people which have had facelifts don’t end up looking like “themselves” and there is nothing they can do about it.
There are significant risks other than those mentioned which include permanent numbness, nerve damage, hemorrhage, need for corrective surgeries.

A little background about Sculptra and Ulthera is in order. Sculptra is a “collagen stimulant” which is used to replenish volume to a person’s face. It is injected in a series of treatments (usually 3) in the office in a 15-20 minute procedure. The results aren’t appreciated for about 6 weeks, the time it takes the body to create the collagen. It has been FDA approved since 2004. Initial concerns regarding nodules have been addressed with using different protocols and now that problem is less than 1%. Ulthera is a noninvasive skin tightening device. It has been FDA approved for over 3 years. It uses high frequency ultrasound to heat up the deeper levels of the skin to contract, lift, and produce collagen. It can improve the neck, brows, cheeks, and jawline. The procedure is done in the office with just topical anesthesia in 30-90 minutes, depending on how many areas treated. Further information on these procedures can be obtained by reading my blogs and watching my YouTube videos.

The reasons that Sculptra and Ulthera are better than a Facelift:

There is no significant downtime with either Sculptra of Ulthera besides the possibility of some minor bruising.
There are no scars, no anesthesia risk, and no post procedure pain significant enough to require pain medication
There is no time required to stay out of work, therefore no lost wages.
Ulthera can address skin laxity in the entire face – forehead, eyebrows, cheeks, jawline, upper and lower neck whereas these are all separate surgical procedures with their associated additional costs and risks.
Ulthera can be repeated for additional tightening without any additional risk (a redo facelift has significant increases in risk) and there are NO LONG TERM reported risks.
Sculptra is an “off the shelf” long lasting volumizer, not requiring liposuction (fat grafting does). Sculptra addresses the primary reason for facial aging by replenishing the volume in the areas where fat and bone have been lost.
By addressing loss of volume with Sculptra, there is a lifting effect on the cheeks, jawline, upper neck, and around the eyes and eyebrows.
The cost of the combination of Sculptra and Ulthera is much less than comparable surgical procedures particularly if you include loss of work compensation.
The results take several months to achieve and are a gradual and natural enhancement. No shocking your friends with a different looking “you”.

We are entering into a new age of cosmetic enhancements. Procedures are less invasive, less downtime, less risk, and more natural. The Gold Standard of having a facelift for correcting the aging face is having some serious competition from the facial volumizer Sculptra and the noninvasive skin tightening procedure Ulthera.

This link shows the limited benefit of facelifts. Only 3 years knocked off your looks and no improvements in attractiveness. http://www.dailymail.co.uk/news/article-2382922/How-facelifts-make-look-younger-just-3-years.html?ito=feeds-newsxml

Blog: stevenfweinermd.wordpress.com

YouTube Channel: StevenFWeinerFacial

Website: www.theclinique.net

Steven F. Weiner, MD demonstrates the Liquid Facelift

Questions Answered by Dr. Weiner on Radiesse

This is Dr. Weiner from The Aesthetic Clinique, demonstrating a Liquid Facelift. A Liquid Facelift is when dermal fillers are used to replace lost volume in the entire face which has occurred due to aging, exercise, and/or weight loss. With no incisions or cutting, you can lift the skin around the eyes, upper cheeks, and improve the jawline and upper neck by just injecting fillers. He uses Radiesse, Belotero, and Xeomin to improve the tear troughs, temples, upper and lateral cheeks, preauricular area, jawline, jowls, nasolabial folds, lip lines, frown lines, crows feet, bunny lines, and forehead wrinkles. She had minimal bruising, and went to work later that day. Blunt microcannulas were used in all but the lip line area (the only area which bruised). www.theclinique.net 850.622.1214

Dr. Steven F. Weiner’s Top 10 Beauty and Longevity Recommendations

After being a physician for 25 years, I have read countless medical journals and listened to hundreds (if not thousands) of lectures. I have sifted through all those years to come up with my top 10 recommendations for a long and beautiful life. Here is my last 25 years summed up:

Topical Retin A – Some sort of Retin A, Retinol, Tretinoin used regularly will keep the skin youthful, vibrant, less pigmented, and minimize acne breakouts. It accelerates skin turnover, decreases sebaceous secretions, thickens the dermis, hydrates the skin, and reverses DNA damage which could lead to cancers. There is over 25 years of research behind this compound so don’t worry over side effects from prolonged use.
Antioxidants – Oxygen free radicals are the main cause of aging and cancer. These are produced daily throughout our body and skin. There are numerous articles touting the benefits of red wine, chocolate, and fruits for their health impact which is mainly due to their antioxidant qualities. Dr. Weiner is especially fond of GliSODin Skin Nutrients which contains the very powerful enzyme, Superoxide Dismutase (SOD). Antioxidants (several are found in SkinMedica TNS Essential Serum) placed directly on the skin help protect from the damaging sun rays. Resveratrol, the antioxidant found in red wine has been thoroughly studied to have benefits for multiple medical conditions (we sell MegaResveratrol). Other oral antioxidants I recommend: bromelin, tumeric, astragalus, polypodium leucotomos (Heliocare), vitamin C, co-enzyme Q10, selenium.
Aspirin – A daily baby aspirin, 81mg, will help prevent strokes, heart attacks, and cancers. Make sure it’s a coated aspirin to prevent stomach ulcers. Remember that the blood thinning effects will last 12 days.
Stay trim – This is a fairly broad recommendation which includes eating right, regular exercise, and choosing active recreational sports. Don’t be a couch potato.
Don’t smoke – Smoking strangulates the skin and other vital organs. The blood vessels contract with the drugs in tobacco. Smoking cessation can reverse most of the damage created so it’s never too late. There is no question at this time that a smoker’s risk of heart attack, stroke, cancer, and lung disease are significantly elevated.
Minimize sun exposure – The number one cause of collagen loss in our skin is sun exposure. Protecting with sunscreen and antioxidants will reduce this breakdown. Skin cancers – melanoma, basal cell, squamous cell, have all been linked to sun exposure. Cataracts can also be caused by the sun so wear sunglasses. Wear hats, rash guards, and use an umbrella when at the beach.
Moderate Alcohol Consumption – There has been numerous studies which tout the benefit of 1-2 drinks per day. Some studies have shown this to be almost as efficacious as exercise. The benefits are lost with consumption that is higher than 2 drinks per day and becomes detrimental.
Daily Exercise – Keeping in good physical shape is beneficial to the heart, lungs, bones, and mental health. It also helps maintain your body weight which is very important as stated in #4.
Don’t wait too long to see a doctor when having problems – I can’t tell you how many times I’ve seen people walk into my office with an obvious cancer. The treatment becomes much more difficult the longer you wait. Its not going to go away if you ignore it. So if you experience a growth, abnormal bleeding or bruising, rapid weight loss, prolonged fevers, night sweets, chest pains, non traumatic body aches, or new neurologic symptoms, please see your doctor soon.
Maintain social awareness, activities – Its important to keep abreast of current affairs, participate in local activities and maintain friendships. It keeps your brain stimulated and mental health stable. Challenge your brain with learning new things, word and math problems, reading, and new hobbies. Go back to school, change jobs or careers to keep stimulating yourself. Don’t fall into a routine which becomes mundane.

Did you know…..Interesting things to do at the Aesthetic Clinique

This blog entry is filled with random facts and procedures that many people don’t know are available at The Aesthetic Clinique.

Aging of the hands can be improved with filling the back of the hand with Radiesse and getting rid of the age spots with the VBeam or Fraxel Dual. Filler in this area is practically pain-free.
Chronic, recalcitrant acne can be treated with near Accutane results using Levulan. Two or three treatments are needed. The results can improve the acne 80% or more for a year or longer.
The temples are a common area of fat loss as we age and can be filled with filler in a few minutes with Sculptra, Radiesse, or Restylane.
Belotero is a new filler that can be injected more superficially than other fillers and is great for those fine lines around the mouth and cheek area.
Blunt cannulas for dermal fillers significantly decreases the discomfort and bruising that normal needles injections cause. We’ve been using cannulas since early 2011.
Those enlarged vessels around the nose and those small red spots on the body (cherry angiomas) can be treated quickly and with very little discomfort with our VBeam.
Ulthera, our non-invasive skin tightening device which uses ultrasound, has recently been approved for the entire neck. It has already been used by us for years on the face. Studies are ongoing for the chest as well as for reducing sweat in the underarms.
Sculptra is now being used to improve the loose, thin skin and wrinkles of the chest.
Facial slimming can be done with Botox for those people who have enlarged masseter muscles.
To improve healing in a surgical or traumatic scar, we are treating with the VBeam when the stitches are removed or the skin is healed.
Precancers on the face can be treated with the Fraxel Dual or Levulan without the need for surgery.
Sculptra not only improves the volume loss of the face, but also improves the skin quality by thickening it.
The duration of bruising after a procedure can be shortened to just a few days when treated with the VBeam a day or two later.
We have a chemical peel which can be done on the eyelids with very little downtime. We also have peels for the body.
With our new Coolcurve handpiece for Coolsculpting, we are now able to treat smaller areas, including inner thigh, male breast tissue (gynecomastia), banana rolls, or very small love handles.
We have a new freezing device from Europe that can take off benign skin lesions, tags, and warts almost painlessly.

For more information, please visit our website: www.theclinique.net